Diet, exercise freed me from diabetes

Munge Wachira was placed on medication after being diagnosed with Type 2 diabetes at 25.

Acceptance was a tall order for Wachira, knowing he was going to spend all of his life battling a progressive chronic condition. But 20 years later, Wachira, now 45, lives a normal life, having been remitted from Type 2 diabetes since 2019.

“I have been fighting diabetes for the better part of my life. I cannot believe I am no longer waking up with a glass of water to take tablets to maintain my sugar levels. God is gracious,” says Wachira, who learnt of the remission during a regular medical check-up in Nairobi.

With Type 2 diabetes, the body uses insulin ineffectively. The condition is mainly caused by excess body weight and physical inactivity.

Globally, more than 95 per cent of diabetes patients have the Type 2 variant, according to the World Health Organisation (WHO). Wachira was one of them.

A doctor placed him on a therapeutic form of diet (without carbohydrates) and exercise, walking 10km to 17km daily. He was also restricted on the fruits he could take. He mostly took those low on sugar like strawberries and blueberries.

“I do not take any wheat. My diet consists of fatty meat, butter, cheese, animal fat, vegetables, chicken, red meat and fish,” Wachira says.

“Nutrition and exercise are key in management of Type 2 diabetes.”

Wachira is among thousands who have been remitted.

“Type 2 diabetes patients should not lose hope,” he says, “They should have a positive mind, listen to their doctors’ instructions and undertake regular check-ups.”

With type 2 diabetes, management can be achieved with oral drugs in the first few years of diagnosis, but it progresses to insulin with time.

Wachira is now a Keto coach. Keto is a programme on weight loss. He is also a motivational speaker on Type 2 diabetes remission.

Daniel Katambo, a diabetes specialist and who studied remission of Type 2 diabetes in the UK, says remission is a new concept that is giving hope to Type 2 diabetes patients.

“Initially, patients and health experts clustered Type 2 diabetes as a progressive chronic condition that places patients on medication and insulin, for their entire lives,” says Dr Katambo.

Currently, however, studies have found that type 2 diabetes remission is possible even without the patients’ and healthcare providers’ knowledge, which has seen many stick to insulin use.

Blood sugar levels

He defines remission as maintaining blood sugar levels at an average of HbA1c (measure of long-terms glucose levels) for three months. Guidelines reveal that remission is higher in patients with less than seven years since diagnosis.

The HbA1c (haemoglobin diabetes test) should be less than 6.5, maintained through lifestyle without any form of medicine.

Studies published in Diabetes Care by a group of international medical organisations last August show that remission can be attained through lifestyle changes, weight-loss and medication.

Lifestyle helps as therapeutic diets have been effective in putting patients into remission with low uptake of carbohydrate diets (less than 130g per day) being the most popular besides ketogenic diet, which is basically using a low carbohydrates diet to eliminate between 30g to 50g per day.

Another method, though unpopular, is using low calories diet; picking liquid diet formulated from hospital to give between 600g to 800g for eight weeks, before slowly graduating to very low calories, which “helps a patient lose weight quickly; more than 10kg to 15kg within two months,” explains Dr Katambo. “This tool is used more so among obese patients.”

Patients diagnosed with diabetes inside seven years attain remission earlier, compared to those with more years, according to the specialist.

Diabetes management

“Once put on lifestyle diabetes management, it takes between two, three or nine months, or even a year, depending on an individual. Patients stay on remission longer, so long as they maintain a healthy living,” says Katambo, who has trained more than 300 health professionals from various cadres on remission.

Studies have shown that remission is more likely among patients who receive treatment to lower their blood sugars sooner after being diagnosed with diabetes.

The Diabetes Remission Clinical Trial (Direct) study that was published in The Lancet in March 2019, showed that diabetes Type 2 can be reversed.

In the study, funded by Diabetes UK and led by experts at Newscastle University and University of Glasgow, led by Prof Roy Taylor from Newcastle University, at least a third of patients with Type 2 diabetes who took part in a weight management programme remained free from diabetes.

“The average HbA1c fell from 60 mmol/mol at the start of 54mmol/mol at the end of year two. Diabetes medication use dropped from 75 per cent of the group to 40 per cent,” reads the study findings in part.

Further, scientists have observed that weight loss can lead to reduced levels of fat inside the pancrease, which, in turn, is associated with the recovery of the organ’s functioning and insulin production.

“The results confirm that remission is closely linked to weight loss. At least 64 per cent of participants who lost over 10 kilos (1 stone 8ib) were in remission after two years,” the study says.